Pennsylvania exchange to offer among lowest-cost premiums

HARRISBURG, Pa. — Pennsylvania residents who buy health insurance in the federally run online marketplace that opens next week will pay below the national average, and the state ranks 10th-lowest out of 47 for which data were available, according to figures released by the Obama administration Wednesday.

The state average is $286 a month for a mid-range plan, not including out-of-pocket costs or tax credits that benefit lower-income families, the figures showed. That’s below the $328 national average.

Variables including income, family size, age, hometown and tobacco use could make the premiums dramatically different for people buying in the marketplace, also known as exchanges, which are a key part of President Barack Obama’s signature health care law.

Factoring in tax credits, a family of four in Pennsylvania with $50,000 in annual income will pay an average of $282 a month for a benchmark policy known as the second-lowest-cost silver plan. It would cost $675 without the credits. A 27-year-old in Pennsylvania making $25,000 a year will pay on average $145 per month for the same policy, or $187 before the tax credit.

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The federal government is running Pennsylvania’s marketplace because Gov. Tom Corbett declined to host a state-run exchange.

A state Department of Insurance spokeswoman said Wednesday it was premature to comment on the figures released by the U.S. Department of Health and Human Services, but noted that the information is still subject to change and only offers a few snapshots of what someone might pay.

Under the 2010 federal health care law, uninsured Americans required to have insurance in 2014 or else pay a penalty will be covered in one of two ways. Also, insurance companies may not increase prices for pre-existing conditions, or deny someone coverage because of one.

Many people, ranging from lower-income workers to the middle class, will qualify for tax credits to help buy a private plan through. The government will send the money for the tax credit directly to insurers, and policyholders will pay any remaining premium.

One hitch in Pennsylvania is that it is likely that many childless adults and some others with incomes below 100 percent of the federal poverty level — $11,490 for a single person — will not be eligible for a tax credit or for Medicaid because Corbett and the state Legislature have not signed on to a Medicaid expansion that was envisioned by the 2010 federal health care law.

A recent study by Families USA, a group that supports the health care law, said nearly 900,000 Pennsylvanians would qualify for a federal tax credit.

Four levels of coverage will be offered on the exchange: bronze, silver, gold and platinum. Bronze plans generally have the lowest premiums but cover less while platinum plans have the highest premiums and cover more.

If a 27-year-old Pennsylvania resident with $25,000 in annual income buys a bronze plan, he or she will pay $109 on average per month after the tax credit, $36 less than for a silver plan. A family of four earning $50,000 per year will pay $152, $130 less per month than for a silver policy.

A silver plan covers 70 percent of medical costs, so policyholders will pay the difference up to an annual out-of-pocket cap.